Active NPI
Kimberly Anne Kittinger, PT
- Pediatric Physical Therapist
- Fresno, CA
National Provider Identifier
1598408403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- PT22904
- Practice address
- 4539 N Brawley Ave Ste 105
Fresno, CA 93722-3950 - Phone
- (559) 594-7118
- NPI assigned
- Apr 18, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | PT22904 | CA | Primary |
Addresses
Primary practice location
4539 N Brawley Ave Ste 105
Fresno, CA 93722-3950
Mailing address
4539 N Brawley Ave Ste 105
Fresno, CA 93722-3950
Phone (559) 594-7118
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT22904 | CA | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650240000000",
"number": "1598408403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4539 N BRAWLEY AVE STE 105",
"city": "FRESNO",
"state": "CA",
"postal_code": "937223950",
"telephone_number": "559-594-7118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4539 N BRAWLEY AVE STE 105",
"city": "FRESNO",
"state": "CA",
"postal_code": "937223950",
"telephone_number": "559-594-7118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KITTINGER",
"first_name": "KIMBERLY",
"middle_name": "ANNE",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-04-18",
"last_updated": "2022-04-18",
"certification_date": "2022-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "CA",
"license": "PT22904",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.